Brain development/Law/Policy Medicine

For malnourished children, new therapeutic food boosts gut microbes, healthy development

Researchers at Washington University School of Medicine in St. Louis and the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh, are developing a new approach to address childhood malnutrition. They are designing therapeutic foods aimed at repairing the gut microbiomes of malnourished children. In a clinical trial of moderately malnourished children in Bangladesh, the team found that a type of therapeutic food they developed is superior to standard therapy. Pictured is a Bangladeshi mother and child in the Nutritional Rehabilitation Unit of the International Centre for Diarrhoeal Disease Research Hospital in Dhaka. (Photo: International Centre for Diarrhoeal Disease Research)

A new type of therapeutic food, specifically designed to repair the gut microbiomes of malnourished children, is superior to standard therapy in an initial clinical trial conducted in Bangladesh.

An interdisciplinary team of investigators from Washington University School of Medicine in St. Louis and the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh, have undertaken a new approach for addressing the pressing global health problem of childhood malnutrition. Their approach focuses on selectively boosting key growth-promoting gut microbes using ingredients present in affordable, culturally acceptable foods.

Their work supports the notion that healthy growth of infants and children is inexorably linked to healthy development of their gut communities following birth. The results of their research are described in two reports published July 12 in the journal Science.

“We found that children who are malnourished have incompletely formed gut microbial communities compared with their healthy counterparts” said senior author Jeffrey I. Gordon, MD, the Dr. Robert J. Glaser Distinguished University Professor and director of the Edison Family Center for Genome Sciences & Systems Biology at the School of Medicine. “Therefore, we set about to design therapeutic foods to repair this immaturity and to determine whether such repair would restore healthy growth.”

The clinical trial, which was conducted by a team led by Tahmeed Ahmed, the International Centre for Diarrhoeal Disease Research’s director of Nutrition and Clinical Services, included 63 Bangladeshi children, 12-18 months of age, diagnosed with moderate acute malnutrition, meaning the children were ill but not close to death. The children were randomly assigned to one of four treatment groups. Children in three of the groups each received one of the three newly designed therapeutic foods, while those in the fourth group received a standard therapeutic food that was not designed based on a consideration of its effects on the gut microbiome.

All foods for the trial were locally produced at the International Centre for Diarrhoeal Disease Research. Children were brought twice daily to a nutritional rehabilitation center, where the therapeutic foods were administered by their mothers under the supervision of health-care workers. A set of measuring tools, developed through advances in genomic medicine, provided a new, much more comprehensive definition of molecular features associated with malnutrition, its underlying mechanisms, and the effectiveness of treatment.

One of the therapeutic foods stood out from the rest, even in this relatively short one-month trial. Measuring 1,300 blood proteins, including those intimately involved in directing bone growth, development of the brain, immune function, and metabolism in various tissues, revealed that this food prototype had produced a pronounced shift toward a healthy state compared with what was observed in the other three groups of children.

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